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Recent reports have highlighted human rights concerns in Ugandan mental healthcare. This article describes the current situation in terms of healthcare funding and provision, concerns regarding legislation, and health inequalities. Possible reasons for the difficult situation are briefly discussed, including the economy, pervasive stigma and ongoing unrest in the region. We then describe some encouraging initiatives in Uganda that are empowering those with mental health problems to have a better quality of life and identify opportunities for change.

Coercion remains a dominant theme in mental healthcare and a source of major concern. While the presence of coercion is ubiquitous internationally, it varies significantly in nature and degree in different countries and is influenced by a variety of factors. Recent reports have raised concerns about physical restraint and the increasing use of legislation in high-income countries. At the same time, a recent Human Rights Watch report on pasung (the practice of tying or restricting movement more generally) in Indonesia has served to highlight the plight of many in middle- and lower-income countries who are subject to degrading and dehumanising ‘treatment’.

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory out-patient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the ‘move into the community’.

Coercion has always been integral to the care and treatment of people who are mentally ill and there is no ‘perfect’ model in which coercion is absent. A number of interventions have shown promise in reducing the use of coercion, however, and we believe the evidence points to ways forward that may improve both the experience and the outcome of care.

There is robust evidence that electroconvulsive therapy is an effective treatment for some mental illnesses. Despite this, its use remains controversial and is declining in some countries, with a consequent loss of skills and knowledge. This, and the view of it as a ‘treatment of last resort’, may undermine its sustainability.

Kenya's Mental Health Act 1989 is now outdated. It is a signatory to international rights conventions that provide for state protection of the rights of people with mental illness, their property and their treatment. There is, however, a glaring failure to implement the existing legal provisions. A new Mental Health Bill that aims to respond comprehensively to the challenges affecting mental health services in Kenya is awaiting enactment. [ABSTRACT FROM AUTHOR]

Coercion remains a dominant theme in mental healthcare and a source of major concern. While the presence of coercion is ubiquitous internationally, it varies significantly in nature and degree in different countries and is influenced by a variety of factors. Recent reports have raised concerns about physical restraint and the increasing use of legislation in high-income countries. At the same time, a recent Human Rights Watch report on pasung (the practice of tying or restricting movement more generally) in Indonesia has served to highlight the plight of many in middle- and lower-income countries who are subject to degrading and dehumanising 'treatment'. [ABSTRACT FROM AUTHOR]

There is robust evidence that electroconvulsive therapy is an effective treatment for some mental illnesses. Despite this, its use remains controversial and is declining in some countries, with a consequent loss of skills and knowledge. This, and the view of it as a 'treatment of last resort', may undermine its sustainability. [ABSTRACT FROM AUTHOR]

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory outpatient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the 'move into the community'. [ABSTRACT FROM AUTHOR]

Coercion has always been integral to the care and treatment of people who are mentally ill and there is no 'perfect' model in which coercion is absent. A number of interventions have shown promise in reducing the use of coercion, however, and we believe the evidence points to ways forward that may improve both the experience and the outcome of care. [ABSTRACT FROM AUTHOR]